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Medical Science Monitor Basic Research


Primary Brain Melanoma in a Pediatric Patient: A Case Report

Gretchen A. Otero-Soto, Viviana Vidal-Anaya, Eduardo J. Labat

Puerto Rico Department of Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico

Am J Case Rep 2021; 22:e926749 :: DOI: 10.12659/AJCR.926749

Available online: 2021-02-01, In Press, Corrected Proof

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The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


BACKGROUND Primary malignant melanoma of the brain is a challenging radiological diagnosis and a high index of suspicion is required about patients with the condition. In the pediatric population, only a few cases have been reported in the literature. The purpose of this report was to describe the expected imaging characteristics and the importance of a multidisciplinary approach in the diagnosis of this rare entity.
CASE REPORT A 17-year-old Hispanic male who presented with new-onset tonic-clonic seizures had no focal neurologic deficits on physical examination. An initial computed tomography scan showed a hyperdense, right frontal, parafalcine mass. Brain magnetic resonance imaging was performed and revealed a T1 hyperintense and T2 hypointense, right-frontal-lobe, extra-axial mass with foci of susceptibility. Resection of the mass revealed a lesion that had a dark, pigmented macroscopic appearance. Histopathologic analysis confirmed that it was a primary intracranial malignant melanoma after no primary site was identified on dermatologic and ophthalmologic evaluations.
CONCLUSIONS Diagnosing a primary intracranial melanoma with imaging alone is virtually impossible if clinical data and findings from a thorough physical examination are unavailable. Intracranial primary malignant melanoma remains a complex radiological diagnosis that relies on the exclusion of other potentially more common entities and an optimal multidisciplinary approach.

Keywords: Adolescent; Brain; Melanoma